Association of Angiotensin Converting Enzyme I/D and α-actinin-3 R577X Genotypes with Growth Factors and Physical Fitness in Korean Children

전체 글

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131

http://dx.doi.org/10.4196/kjpp.2015.19.2.131 eISSN 2093-3827

ABBREVIATIONS: ACE, angiotensin converting enzyme; ACTN3, α- actinin-3; I, insertion; D, deletion.

Received November 21, 2014, Revised January 29, 2015, Accepted January 29, 2015

Corresponding to: Kijin Kim, Department of Physical Education, College of Physical Education, Keimyung University, 2800 Dalgubeoldaero, Dalseo-gu, Daegu 704-701, Korea. (Tel) 82-53-580- 5256, (Fax) 82-53-580-5314, (E-mail) kjk744@kmu.ac.kr

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://

creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Association of Angiotensin Converting Enzyme I/D and α-actinin-3 R577X Genotypes with Growth Factors and Physical Fitness in Korean Children

Kijin Kim, Nayoung Ahn, Wookwang Cheun, Changbae Hong, Jayoung Byun, and Youngsik Joo Department of Physical Education, College of Physical Education, Keimyung University, Daegu 704-701, Korea

This study analyzed the differences in aerobic and anaerobic exercise ability and growth-related indicators, depending on the polymorphism of the ACE and the ACTN3 genes, to understand the genetic influence of exercise ability in the growth process of children. The subjects of the study consisted of elementary school students (n=856, age 10.32±0.07 yr). The anthropometric parameters, physical fitness and growth factors were compared among groups of the ACE I/D or the ACTN3 R577X polymorphisms. There were no significant differences between the anthropometric parameters, physical fitness and growth factors for the ACE gene ID or the ACTN3 gene R577X polymorphism. However, the DD type of ACE gene was highest in the side step test (p<0.05), and the DD type was significantly higher than the II+ ID type (p< 0.05) in the early bone age. The combined group of the ACE gene II+ ID and the ACTN3 gene XX type significantly showed lower early bone age (p< 0.05). This study did not find any individual or compounding effects of the polymorphism in the ACE I/D or the ACTN3 R577X polymorphisms on the anthropometric parameters, physical fitness and growth factors of Korean children. However, the exercise experience and the DD type of the ACE gene may affect the early maturity of the bones.

Key Words: ACE gene I/D, ACTN3 gene R577X, Growth, Physical fitness, Children

INTRODUCTION

Genes that have the potential to affect physical fitness consist of types sensitive to training [1-4]. It is considered that the gene polymorphism of the angiotensin converting enzyme (ACE), found in the heart and the skeletal muscles, is closely related to the physical fitness level based on car- diopulmonary function and anaerobic performance [5,6].

The renin-angiotensin system adjusts blood pressure, body fluid and electrolyte concentrations, and is known to affect cardiopulmonary endurance. It is reported that individuals with the II genotype have lower blood pressure and higher cardiopulmonary endurance than those with the DD geno- type, who have increased risk of developing cardiovascular diseases [7]. Yet ACE genotype is not a determinant of elite sprint athlete status [8]. Different results [9], however, have been reported as a result of the differences in the

physical features among races, gender and diseases [10].

The related mechanism is largely unknown [11].

The α-actinin-3 protein, expressed from the ACTN3 gene, is the main component of the Z line, where both tips of the myomere where the actin filament is crossed are known to be influential factor on exercise ability of exerting muscular strength. It is a main protein required to exert maximum muscular strength, expressed from type II mus- cular fibers and distinguished from the α-actinin-2, the iso- form expressed from all the muscular fibers of the slow and the fast muscles [12,13]. While the XX genotype (R577X), one of the gene polymorphisms of the ACTN3, does not ex- press α-actinin-3 in the fast twitch muscle fibers, the RR genotype (577R) normally expresses α-actinin-3 in fast- twitch myofibers which is considered to be an influential part in producing forceful muscle contractions at high veloc- ity that can be advantageous for sports requiring anaerobic muscular strength and power [14]. Yang et al. [13] showed that the Australian sprinter group had significantly lower frequency of the XX genotype of the ACTN3 gene than the general group, and higher RR genotype. However, the en- durance group had much higher frequency in the XX geno- type [13], indicating that the 577R opponent of the ACTN3 gene affects the sprint genotype. But the Kenyan and Ethiopian athletes with strength in the endurance show the XX genotype of the ACTN3 gene polymorphism similar to

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general group [15], and ACTN3 XX genotype is negatively associated with elite sprint athlete status, the underlying low frequency in these populations eliminates the possibility of replicating this association in Jamaican and US African American sprinters [8]. As previous findings have not al- ways been replicated, the extent to which ACTN3 or ACE genotypes influence physical fitness-related phenotypes varies. The genotype and some phenotype might be related each other but the causality could not claim.

As mentioned above, despite evidences showing differ- ences between aerobic and anaerobic exercise performance depending on the polymorphism of the ACE and the ACTN3 genes in skeletal muscles, more studies are required to un- derstand genes and exercise training adaptation [4,16]. In addition, studies examining the contributions of these spe- cific genes and their polymorphism and regular exercise on the growth trend of children are still insufficient. Therefore, this study analyzed the differences in aerobic and anaerobic exercise ability and growth-related indicators depending on the polymorphism of the ACE and the ACTN3 genes and to understand the genetic influence of exercise performance on the growth process of children.

METHODS Subjects

The subjects of the study were 856 elementary school stu- dents (10.32±0.07 years) including 126 athletes (male: n=

98, female: n=28) and 730 non-athletes (male: n=524, fe- male: n=206) based upon 6 months athletic career. Ques- tionnaires were used to select participants and those with physical disabilities or diseases were not included in the study. Informed consent for participation was sought from the parents of the participants. The study protocol was in compliance with the Code of Ethics of the World Medical Association (Declaration of Helsinki), and had previously been approved by the Institutional Review Board of the Keimyung University (IRB NO 11-233).

Analysis of the physique and blood parameters The height and the weight were measured and the body mass index (BMI) was calculated using the formula, ‘body weight/height2 (kg/m2)’. The subjects who fasted for more than 12 hours, are rested for 30 minutes then 10ml of the blood was drawn from the antecubital vein. The concen- tration of IGF-1 in the serum was measured by ELISA kit (Diagnostics Systems Laboratories, USA), and the growth hormone was measured by Radio Immuno Assay method using the GH measurement kit (RIA kit, LINCO Research, INC, USA).

The genotypes of ACE and ACTN3

Plasma obtained from EDTA tubes was used to obtain genomic DNA from the monocytes by the phenol-chloroform extraction method. Primers (Bionix INC, Seoul, Korea) were used to amplify the ACE genes. The sense primer was 5'-CTGGAGACCACT CCCATCCTTTCT-3' and the antisense primer was 5'-ATGTGGCCA TCACATTCGTCAGAT-3'. The polymerase chain reaction was performed as below using the PC320 (ASTEC, Japan). PCR product was confirmed by electrophoresis. A band was observed at 490 bp for type

II, 2 bands were observed at 190 bp and 490 bp for the ID type and a band was observed at 190 bp for the DD type. All the samples of the DD type were PCR again to prevent the error that the DD type may be included in the ID type. For the 2nd PCR, sense primer 5'-TGGGACCACA GCGCCC GCCACTAC-3' and the antisense primer 5'-TCG CCAGCCCTCCCATGCCCATAA-3' were synthesized. The PCR product was electrophoresed. A band was observed at 310 bp for the ID type. The ACTN3 gene was also analyzed by PCR. The sense primer was 5'-CTGGAGACCACTCCC ATCCTTTCT-3' and the antisense primer was 5'-ATGTGGC CATCACATTCGTCAGAT-3'. The XX type showed bands at 108 bp, 97 bp and 86 bp, the RX type showed 4 bands at 205 bp, 108 bp, 97 bp and 86 bp and the RR type showed 2 bands at 205 bp and 86 bp.

Physical fitness

Grip, back strength and leg strength were measured with the muscular strength gauge (TTK, Japan). Sit-up were used as a measurement for muscular endurance, sit &

reach for flexibility, side step test and response to light and sound using the reaction time gauge (TTK, Japan) for agil- ity, and physical efficiency index from the Harvard step test for cardiovascular endurance. Power was measured by the vertical jump, long jump, medicine ball throw with under or over, 30 m sprint test and 100 m dash.

Bone growth

The non-dominant hand (mainly left hand) was used for X-ray measurement of bone age. The chronological age is calculated by subtracting the date of taking the X-ray from the date of birth. Bone age is calculated from the X-ray picture taken by the TW2-RUS method. A total of 20 bones were analyzed. The time for completing the bone maturity is when the total bone score reaches 1000. The early bone age is the value extracting the chronological age from the bone age.

Statistical analysis

The anthropometric and biochemical features are pre- sented as mean and SEM. To determine the differences in continuous variables among the three genotype groups ANOVA was employed and a follow up analysis using con- trast test was used when the distribution of the variable or of the logarithmically transformed variable approached a normal distribution and the variances of the variables were equal in the groups compared. Otherwise the Mann- Whitney U test was used. Bonferoni’s test was utilized to determine differences in continuous variables between ACE II+ID and DD or ACTN3 RR+RX and XX with gene al- lele’s types. Using Bonferoni’s test, the combined effect of ACE I/D and ACTN3 R577X polymorphisms on the study phenotypes was analyzed by using four genotype combina- tions, i.e. ACE DD and ACTN3 RR+RX (which, at least hypothetically, might be more suitable for power/hyper- trophy-oriented exercise tasks), ACE II+ID and ACTN3 XX group, ACE II+ID and ACTN3 RX group, and ACE DD and ACTN3 XX group [17,18]. The significance of deviations of observed genotype frequencies from those predicted by the Hardy- Weinberg equation were evaluated with X2 tests between athletes and non-athletes groups. A binary logistic regression model was used to test for the association of ACE

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Table 1. Frequency of ACE I/D polymorphisms and alleles with gender or athletic career

Group Variables Athletes Non-athletes Total

Male Genotype

II 38 (38.8%) 189 (36.1%) 227 (36.5%)

ID 49 (50.0%) 258 (49.2%) 307 (49.4%)

DD 11 (11.2%) 77 (14.7%) 88 (14.1%)

X2 (p value) 0.645

Allele frequency

I 0.638 0.607 0.612

D 0.362 0.393 0.388

X2 (p value) 0.609

OR (95% CI) 1.123 (0.720∼1.750)

Female Genotype

II 10 (35.7%) 78 (37.9%) 88 (37.6%)

ID 17 (60.7%) 101 (49.0%) 118 (50.4%)

DD 1 (3.6%) 27 (13.1%) 28 (12.0%)

X2 (p value) 0.277

Allele frequency

I 0.661 0.624 0.628

D 0.339 0.376 0.372

X2 (p value) 0.826

OR (95% CI) 0.912 (0.400∼2.076)

Total Genotype

II 48 (38.1%) 267 (36.6%) 315 (36.8%)

ID 66 (52.4%) 359 (49.2%) 425 (49.6%)

DD 12 (9.5%) 104 (14.2%) 116 (13.6%)

X2 (p value) 0.357

Allele frequency

I 0.643 0.612 0.616

D 0.357 0.388 0.384

X2 (p value) 0.744

OR (95% CI) 1.067 (0.723-1.576) I/D or ACTN3 R577X genotypes and early bone age, control-

ling for the risk factors of athletic career and gender by calculating the odds ratios (95% confidence interval) and corresponding p values. The level of significance was set at p<0.05.

RESULTS

The genotype distribution of the ACE I/D polymorphism for all the subject shows 36.8%, 49.6% and 13.6% for the II, ID and DD types, respectively and the D allele frequency is 0.384, meeting the Hardy-Weinberg equilibrium. In addi- tion, the athlete group and the non-athlete group reveal almost the same distribution (X2=2.058, p=0.357). Also the distinction between the male (X2=0.878, p=0.645) and the female (X2=2.571, p=0.277) students exhibit almost the same distribution (Table 1). On the other hand, the geno- type distribution of the ACTN3 R577X polymorphism for all the subjects indicate that the RR, RX and XX type are 30.7%, 48.6% and 20.7%, respectively and the X allele fre- quency is 0.450, which also meets the Hardy-Weinberg equilibrium. In addition, the athlete group and the non-ath- lete group show almost the same distribution (X2=0.001, p=0.951). The distinction between the male (X2=0.081, p=0.960) and the female (X2=0.059, p=0.971) students dis- play almost the same distribution (Table 2).

Table 3 shows the comparison of the anthropometric pa-

rameters, physical fitness and growth factors depending on the genotype of the ACE gene I/D polymorphism for all the subjects. Most of these items do not demonstrate significant differences in the genotype except the side step test which shows that the DD type is the highest (p<0.05) and the early bone age shows that the DD type is significantly high- er than the II+ID type (p<0.05).

As shown in Table 4, the comparison of the anthro- pometric parameters, physical fitness and growth factors depending on the ACTN3 gene R577X polymorphism shows no significant difference for all the items in the genotype, and there is no significant difference between the II+ID type and the DD type.

As shown in Table 5, there is no significant difference for all the items except early bone age among the 4 groups (the ACE gene II+ID and the ACTN3 gene XX type group, the ACTN3 gene RR+RX and the ACE gene DD type group, the ACE II+ID and the ACTN3 RX type group, and the ACE DD and ACTN3 XX type group) to analyze the complex impact of the polymorphism in the ACE gene I/D and the ACTN3 gene R577X. However, the group which combines the ACE gene II+ID and the ACTN3 gene XX type shows consistent higher tendency than the group with the ACTN3 gene RR+RX and the ACE gene DD type in the aspect of all the items related to physical fitness, and it shows that the group with the ACTN3 gene RR+RX and the ACE gene DD type is significantly higher than the group with the ACE gene II+ID and the ACTN3 gene XX type for the early

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Table 2. Frequency of ACTN3 R577X polymorphisms and alleles with gender or athletic career

Group Variables Athletes Non-athletes Total

Male Genotype

RR 31 (32.0%) 164 (31.7%) 195 (31.7%)

RX 47 (48.5%) 246 (47.5%) 293 (47.6%)

XX 19 (19.6%) 108 (20.8%) 127 (20.7%)

X2 (p value) 0.960

Allele frequency

R 0.562 0.554 0.555

X 0.438 0.446 0.445

X2 (p value) 0.954

OR (95% CI) 1.014 (0.637∼1.614)

Female Genotype

RR 8 (26.7%) 58 (28.2%) 66 (28.0%)

RX 16 (53.3%) 105 (51.0%) 121 (51.3%)

XX 6 (20.0%) 43 (20.9%) 49 (20.8%)

X2 (p value) 0.971

Allele frequency

R 0.533 0.536 0.536

X 0.467 0.464 0.464

X2 (p value) 0.865

OR (95% CI) 0.928 (0.391∼2.202)

Total Genotype

RR 39 (30.7%) 222 (30.7%) 261 (30.7%)

RX 63 (49.6%) 351 (48.5%) 414 (48.6%)

XX 25 (19.7%) 151 (20.9%) 176 (20.7%)

X2 (p value) 0.951

Allele frequency

R 0.555 0.549 0.550

X 0.445 0.451 0.450

X2 (p value) 0.992

OR (95% CI) 1.002 (0.666∼1.508)

bone age (p<0.05) (Fig. 1).

A logistic regression analysis with early bone age as the dependent variable and ACE I/D genotypes, ACTN3 R577X genotypes, gender, and athletic career showed no associa- tion of the ACTN3 R577X genotypes and gender with early bone age (Table 6). However, athletic career (OR=2.139, p=0.002) or ACE DD type (OR=1.938, p=0.019) conferred an approximately twofold increased effect for early bone age (Table 6).

DISCUSSION

The frequency of D allele of ACE I/D gene was 0.384, and the percentage of DD genotype subjects was 13.6%, which was similar to Korean adults [19] and other Asian population [20,21]. We could confirm the lower prevalence of ACE DD genotype and frequency of D allele of ACE I/D gene in Asian populations as compared with American or European [20-23]. Pitsiladis et al. [24] suggested the typical allele frequencies for the I and D alleles of the ACE I/D polymorphism in a European population are 43% and 57%, respectively.

As the stop codon variant is quite common in human ACTN3 gene, XX homozygotes are in an estimated 1 billion people in the world [25]. The frequency of α-acinin-3-defi- cient genotype (577XX) varies from 25% in Asian pop- ulation to <1% in an African Bantu population; the fre-

quency in Europeans is ∼18%. This raises the possibility that ACTN3 genotype confers differential fitness in humans, under certain environmental conditions [13]. Extremely low 577XX genotype frequencies were observed in Kenyan and Nigerian athletes versus controls (1% vs 1% and 0% vs 0%, respectively), and theirs were much lower than in any other non-African populations, where frequency of the 577XX gen- otype is 18% in Australian Caucasians, 10% in Aboriginal Australians, 18% in Spanish Caucasians and 25% in Japanese [24]. As the frequency of 577XX was 20.7% in this study, we could confirm the higher prevalence of 577XX genotype in Asian populations.

The ACE I/D genotype shows different influence due to a number of reasons including racial features, age groups and exercise status, meaning, it is difficult to draw a con- sistent conclusion on the polymorphism of a single gene.

The ACE gene is a representing candidate which affects the endurance exercise ability and it is considered that the I allele and the D allele affect endurance and anaerobic power [26,27]. The occurrence frequency in the I allele showed a high relationship to endurance as seen in British mountaineers [28], South African triathletes [29], British distance runners [30], and Australian rowers [7]. It is re- ported that the occurrence frequency in the D opponent had high relation to power in short-distance swimming [27], sprinting [30], Poland’s power-based sports [15]. Similar findings were reported in non-athletic populations [31-33].

However, Ash et al. [34] found no significant differences

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Table 3. Anthropometric parameters, physical fitness, and bone growth factors among ACE gene genotypes

Variables II ID DD II+ID p value p value*

Age (yr) 10.69±0.11 10.70±0.09 10.52±0.16 10.70±0.07 0.629 0.196

Height (cm) 144.12±0.76 143.97±063 142.93±1.09 144.04±0.49 0.690 0.391

Weight (kg) 40.83±0.70 40.32±0.56 39.18±1.02 40.53±0.44 0.436 0.251

BMI (kg/m2) 19.26±0.19 19.14±0.16 18.84±0.30 19.19±0.12 0.500 0.211

Body fat (%) 16.58±0.44 16.26±0.34 15.95±0.74 16.40±0.27 0.707 0.468

Back (kg) 42.04±1.13 43.50±1.00 41.56±1.58 42.88±0.75 0.497 0.882

Leg (kg) 152.23±8.23 143.10±7.86 170.00±9.77 147.23±5.68 0.388 0.224

Grip-Left (kg) 17.41±0.42 17.10±0.34 16.54±0.62 17.23±0.27 0.527 0.433

Grip-Right (kg) 18.11±0.44 17.80±0.36 16.93±0.60 17.93±0.28 0.349 0.309

Sit-up (fre) 20.62±0.36 20.33±0.32 19.97±0.53 20.45±0.24 0.628 0.414

Vertical Jump (cm) 49.33±1.41 46.71±1.49 49.60±3.39 47.87±1.05 0.413 0.585

Long Jump (cm) 145.15±1.90 144.94±1.57 139.27±2.97 145.03±1.21 0.213 0.138

Under throw (cm) 687.98±28.80 649.54±26.65 707.40±36.49 666.90±19.56 0.118 0.159 Over throw (cm) 543.03±26.18 497.19±23.66 621.60±45.22 517.89±17.65 0.127 0.118

Side step test (fre) 41.93±0.79 38.00±0.97 43.20±2.56 39.74±0.68 0.006 0.274

RT-light (sec) 0.25±0.01 0.26±0.01 0.26±0.01 0.26±0.00 0.584 0.694

RT-sound (sec) 0.25±0.01 0.25±0.01 0.25±0.01 0.25±0.01 0.881 0.358

30 m sprint (sec) 4.65±0.06 4.66±0.05 4.52±0.14 4.66±0.38 0.635 0.331

100 m dash (sec) 14.00±0.35 13.93±0.34 13.15±0.28 13.97±0.24 0.499 0.244

Sit and reach (cm) 3.17±0.17 3.11±0.14 2.65±0.26 3.13±0.11 0.248 0.046

PEI (%) 60.23±0.62 60.99±0.51 61.15±0.89 60.66±0.40 0.563 0.446

Bone score 450.44±11.59 439.29±9.95 445.37±18.46 444.03±7.55 0.763 0.809

Bone age (yr) 11.49±0.15 11.43±0.13 11.69±0.24 11.45±0.10 0.652 0.434

Predict height (cm) 173.38±0.52 173.82±0.45 173.57±0.72 173.63±0.34 0.810 0.799

Early bone age (yr) 0.80±0.09 0.73±0.08 1.17±0.15 0.76±0.06 0.023 0.006

IGF-1 (ng/ml) 2.76±0.19 2.65±0.14 2.50±0.30 2.69±0.12 0.765 0.593

GH (ng/ml) 1.72±0.28 2.02±0.25 1.25±0.33 1.89±0.19 0.342 0.568

Values are mean and SE. Back/Leg/Grip-Left/Grip-Right, muscular strength; RT, reaction time; PEI, physical efficiency index of Harvard step test; IGF-1, insulin-like growth factor-1; GH, growth hormone.

p value is ANOVA among II, ID, and DD. p value* is Bonferoni’s test between II+ID and DD.

in ACE I/D polymorphism’s distribution in Ethiopian dis- tance runners. Other studies suggested a positive relation- ship in endurance capacity with DD type in young Chinese adults [35], Israel’s endurance runners [36], and Korean athletic runners [37]. In addition, Scott et al. [8] found that ACE genotype was not a key determinant of the success of the world’s top sprinters from Jamaica and the United States. The study may not confirm the impact of the ACE I/D genotype on muscular strength, throwing, jumping and sprint, general parameters of measuring the muscular func- tions and the power. In addition, the PEI, an item related to the cardiopulmonary function, did not show a significant difference depending on the ACE I/D genotype. However, the side step test, an agility item, showed that the DD type is significantly excellent, confirming the positive impact of the DD type on the speed. This means that the ACE I/D genotype may partially affect the agility of the Korean teen- agers but the study may not confirm the significant differ- ence between the physique and the physical fitness in the ACE I/D genotype. Therefore, the relationships between ACE I/D genotypes and physical characteristics or fitness remain ambiguous. It was also found out that the physique, physical fitness and growth indicators did not show sig- nificant differences in the R577X polymorphism of ACTN3 gene. The variant of stop codon 577 of ACTN3 is quite com- mon in humans, with an estimated 1 billion people world- wide being XX homozygotes [25]. Gomez-Gallego et al. [17]

reported that the ACTN3 577RR/RX genotypes highly ap-

peared around the maximal power and the ventilatory threshold level, and Ahmetov et al. [38] claimed that the opponent frequency of the ACTN3 577X was low for endur- ance Russian athletes and related to the performance of rowing athletes. However, the data for the role of the ACTN3 in training response to cardiorespiratory fitness traits were insufficient, while the definitive impacts on the skeletal muscles were not entirely [39,40]. Norman et al.

[41] even argued that it was not an important factor in muscle power or sprint performance. In particular, the hy- pothesis that α-actinin-3 deficiency may positively affect endurance was not be supported by prior studies [42-45].

It is reported that it is rarely related to the maximal oxygen uptake in Spanish or Russian endurance athletes [42,46].

This study on Korean children showed that the ACTN3 R577X genotypes are rarely related to physical fitness levels.

Even though significant features in physical fitness were not found due to individual gene polymorphism, Bouchard [1] proposed that the compounding impact of genes on training was related to the changes in the maximum oxygen intake which can be accurately investigated by the analysis of the complicated genes. However, scarce data are avail- able on the combined influence of ACE I/D and ACTN3 R577X polymorphisms on fitness phenotypes. Rodrigez- Romeo et al. [47] found no differences of peak power output between those cyclists with the ACE DD and ACTN3 RR+

RX and ACE II+ID and ACTN3 XX genotype combinations.

Eynon et al. [48] reported an association between the com-

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Table 4. Anthropometric parameters, physical fitness, and bone growth factors among ACTN3 gene genotypes

Variables RR RX XX RR+RX p value p value*

Age (yr) 10.55±0.13 10.75±0.09 10.70±0.13 10.67±0.07 0.385 0.895

Height (cm) 143.62±0.86 144.46±0.63 143.08±0.95 144.13±0.51 0.458 0.408

Weight (kg) 40.10±0.77 41.00±0.57 39.37±0.85 40.65±0.46 0.273 0.245

BMI (kg/m2) 19.03±0.20 19.30±0.16 18.99±0.25 19.20±0.12 0.439 0.348

Body fat (%) 16.05±0.46 16.93±0.37 15.56±0.55 16.59±0.29 0.090 0.091

Back (kg) 43.37±1.29 42.38±0.96 42.09±1.51 42.76±0.77 0.759 0.705

Leg (kg) 145.75±7.92 148.50±7.67 157.35±16.04 147.19±5.47 0.771 0.759

Grip-Left (kg) 17.11±0.48 17.32±0.34 16.90±0.52 17.24±0.28 0.805 0.768

Grip-Right (kg) 17.75±0.50 17.94±0.35 17.64±0.57 17.87±0.29 0.890 0.766

Sit-up (fre) 19.97±0.40 20.53±0.30 20.74±0.50 20.31±0.24 0.398 0.276

Vertical Jump (cm) 47.14±1.71 48.53±1.41 48.70±1.84 47.86±1.10 0.772 0.762

Long Jump (cm) 144.41±2.10 144.67±1.61 143.72±2.40 144.57±1.28 0.950 0.992

Under throw (cm) 686.68±31.10 656.23±30.69 693.30±43.15 670.68±21.76 0.716 0.490 Over throw (cm) 521.75±24.73 515.49±24.99 542.10±57.44 518.46±17.47 0.877 0.878

Side step test (fre) 40.75±1.01 38.93±0.99 43.40±2.08 39.81±0.71 0.085 0.083

RT-Light (sec) 0.25±0.01 0.26±0.01 0.25±0.01 0.26±0.00 0.279 0.501

RT-Sound (sec) 0.24±0.01 0.26±0.01 0.24±0.01 0.25±0.01 0.267 0.331

30 m sprint (sec) 4.65±0.06 4.66±0.05 4.60±0.10 4.66±0.04 0.842 0.598

100 m dash (sec) 13.73±0.30 14.21±0.37 13.35±0.63 13.94±0.23 0.429 0.495

Sit and reach (cm) 3.17±0.18 3.00±0.14 2.98±0.22 3.06±0.11 0.722 0.670

PEI (%) 60.04±0.62 60.81±0.52 61.33±0.84 60.51±0.40 0.432 0.430

Bone score 429.44±11.96 458.38±10.61 442.75±15.06 446.88±7.98 0.197 0.854

Bone age (yr) 11.36±0.17 11.63±0.13 11.42±0.19 11.52±0.11 0.391 0.812

Predict height (cm) 174.26±0.54 173.28±0.47 173.15±0.68 173.67±0.35 0.319 0.484

Early bone age (yr) 0.81±0.09 0.88±0.79 0.71±0.11 0.85±0.06 0.492 0.433

IGF-1 (ng/ml) 2.69±0.21 2.78±0.14 2.42±0.26 2.75±0.12 0.474 0.132

GH (ng/ml) 1.81±0.31 1.86±0.23 1.66±0.40 1.84±0.18 0.906 0.486

Values are mean and SE. Back/Leg/Grip-Left/Grip-Right, muscular strength; RT, reaction time; PEI, physical efficiency index of Harvard step test; IGF-1, insulin-like growth factor-1; GH, growth hormone.

p value is ANOVA among RR, RX, and XX. p value* is Bonferoni’s test between RR+RX and XX.

Table 5. Comparison of anthropometric parameters, physical fitness, and bone growth factors among the 4 groups Variables ACE II+ID and

ACTN3 XX (n=148) ACTN3 RR+RX

and ACE DD (n=89) ACE II+ID and

ACTN3 RX (n=356) ACE DD and

ACTN3 XX (n=24) p value

Age (yr) 10.67±0.15 10.48±0.19 10.48±0.10 10.27±0.31 0.074

Height (cm) 142.78±1.07 142.60±1.30 144.84±0.69 144.09±2.07 0.277

Weight (kg) 39.03±0.92 38.62±1.15 41.55±0.62 41.18±2.41 0.055

BMI (kg/m2) 18.92±0.27 18.65±0.34 19.45±0.17 19.49±0.74 0.124

Body fat (%) 15.27±0.60 15.55±0.86 17.13±0.39 17.19±1.55 0.053

Back (kg) 42.07±1.74 41.24±1.92 42.68±1.05 41.81±2.39 0.943

Grip-Left (kg) 16.87±0.59 16.64±0.76 17.45±0.37 16.28±0.94 0.630

Grip-Right (kg) 17.67±0.65 17.00±0.74 18.17±0.39 16.70±0.88 0.461

Sit-up (fre) 20.78±0.55 19.90±0.60 20.55±0.34 19.88±1.19 0.737

Long Jump (cm) 144.20±2.65 139.78±3.55 145.48±1.75 136.68±5.44 0.319

Sit and Reach (cm) 3.09±0.24 2.73±0.31 3.06±0.16 2.29±0.51 0.491

PEI (%) 61.11±0.95 60.55±1.04 60.96±0.57 61.99±1.65 0.920

Bone score 436.86±16.45 446.90±22.15 461.81±11.51 448.58±33.69 0.662

Bone age (yr) 11.30±0.22 11.65±0.29 11.68±0.14 11.87±0.42 0.486

Predict height (cm) 173.02±0.74 173.03±0.82 173.38±0.52 175.15±1.56 0.749

Early bone age (yr) 0.63±0.13 1.17±0.18* 0.88±0.08 1.25±0.26 0.048

IGF-1 (ng/ml) 2.28±0.28 2.50±0.34 2.81±0.16 2.50±0.50 0.375

GH (ng/ml) 1.75±0.46 1.30±0.35 1.96±0.26 1.00±1.00 0.646

Values are mean and SE. Back/Leg/Grip-Left/Grip-Right, muscular strength; RT, reaction time; PEI, physical efficiency index of Harvard step test; IGF-1, insulin-like growth factor-1; GH, growth hormone.

p value: One-way ANOVA among 4 groups, *Significant different as compared to ACE II+ID and ACTN3 XX group with Bonferoni’s test.

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Table 6. Logistic regression analysis for association of ACE I/D, ACTN3 R577X genotype and other predictor variables with early bone growth

Variables β SE Wald χ2 p value Odds ratio CI 95%

Athletic career 0.760 0.248 9.398 0.002 2.139 1.316∼3.478

ACE DD genotype 0.662 0.283 5.484 0.019 1.938 1.114∼3.373

ID genotype 0.013 0.220 0.003 0.954 1.013 0.658∼1.558

ACTN3 RR genotype 0.075 0.299 0.063 0.802 1.078 0.600∼1.937

RX genotype 0.398 0.271 2.159 0.142 1.488 0.876∼2.530

Male 0.293 0.211 1.938 0.164 0.746 0.494∼1.127

Athletic career, ACE I/D genotype, and ACTN3 R577X genotype are included as categorical variable.

β, logistic regression coefficient in the model; SE, standard error of the coefficient; Wald χ2, Wald statistic to test significance of the coefficient; CI 95%, Confidence interval of the odds ratio.

Fig. 1. Comparison of physical fitness and bone growth factors between the ACE II+ID and ACTN3 XX and ACE DD and ACTN3 RR+RX groups.

PEI, physical efficiency index of Harvard step test. *p<0.05 Com- pared to ACE II+D and ACTN3 XX genotypes.

bination of both ACE and ACTN3 polymorphisms and elite sprint athletic status. This is different from the earlier find- ing for it proposed that the combination for a sprinter was the ACTN3 R allele+the ACE I allele. Bustamante-Ara et al. [49] reported no association (individually or combined) between power muscle phenotypes and ACE I/D plus ACTN3 R577X genotype combinations in non-athletic eld- erly populations. The study investigated the compounding impact of the ACE gene and the ACTN3 gene for all param- eters related to physical fitness and found no significant difference as well, indicating insufficient results to explain the individual genetic variability. However, as shown in Fig. 1, the group where the ACE gene II+ID and the ACTN3 gene XX type were combined shows consistent high- er tendency in all the physical fitness parameters than those of the group with ACTN3 gene RR+RX and the ACE gene DD types, indicating a possibility that the I and D alleles of the ACE gene are determinants of endurance and

power, respectively, and that the R and the X alleles of the ACTN3 gene are prominent in power and endurance, respectively. It is possible that proper combinations of the 2 genetic opponents may be prominent to specific physical fitness parameters. However, young children may develop overall physical fitness in the early stage if the I allele of the ACE gene and the X allele of the ACTN3 are combined.

It is suggested that the combined influence of ACE I/D and ACTN3 R577X polymorphisms on fitness phenotypes may affect others depending on the degree of experience in the exercise and on age wherein the ACTN3 X allele+the ACE I allele may positively affect the overall improvement in the physical fitness before the peculiarity in exercise ability emerges. The relationship between growth pace and genetic polymorphism in young children showed that early bone age was affected by the ACE DD type and exercise experi- ence with the group combining the ACTN3 gene RR+RX and ACE gene DD types being significantly higher than the

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group with the ACE gene II+ID and ACTN3 gene XX types (p<0.05).

Claims that regular exercise may positively stimulate growth in young may not be always true because of com- pounding variables [26]. Family and twin studies have esti- mated that up to 60∼80% of the variance in peak bone mass is attributable to genetic factors [50]. Regular exercise induces several beneficial changes in organs and biological pathways that lead to better physical performance and im- proved health outcomes. It is not clear, however, how ex- ercise affects growth, which may depend on gender as well as specific features of the bones including the skeletal parts and the bone density [51]. It is evident that there are marked individual differences in physiological changes brought about by regular physical activity. It may be ad- vantageous to have early morphological traits that favor performance in these competitive activities or a genotype that drives a slower rate of sexual maturation. In contrast, boys who excel in competitive sports tend to exhibit ad- vanced skeletal and sexual maturity [52]. The exercise ex- perience and the DD type of the ACE gene affect the early maturity of bones but how such growth stimulation affects the physique development warrants confirmation. We should consider that genes influence phenotypes varies in response to gender and athletic career. We performed an analysis based on the ossification process of the hand be- cause of the possibility that early ossification may neg- atively affect growth [53]. The significant impact of the ACE DD type on early bone age may be considered as a related anabolic factor for the ACE DD type in the genetic aspect of the growth. However, additional confirmation is required because the growth hormone and the blood concen- tration of the IGF-1 show no significant difference between both individual and complex analyses of the ACE and ACTN3 gene polymorphism.

In conclusion, exercise and the DD type of the ACE gene may affect the early maturity of bones. Further research is needed to confirm these relationships.

CONFLICT OF INTEREST The authors report no conflicts of interest.

ACKNOWLEDGEMENTS

This work was done with the sports promotion fund from Korea Institute of Sport Science, Korea Sports Promotion Foundation (KISS-11-A01001).

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수치

Table 1. Frequency of ACE I/D polymorphisms and alleles with gender or athletic career

Table 1.

Frequency of ACE I/D polymorphisms and alleles with gender or athletic career p.3
Table 2. Frequency of ACTN3 R577X polymorphisms and alleles with gender or athletic career

Table 2.

Frequency of ACTN3 R577X polymorphisms and alleles with gender or athletic career p.4
Table 3. Anthropometric parameters, physical fitness, and bone growth factors among ACE gene genotypes

Table 3.

Anthropometric parameters, physical fitness, and bone growth factors among ACE gene genotypes p.5
Table 4. Anthropometric parameters, physical fitness, and bone growth factors among ACTN3 gene genotypes

Table 4.

Anthropometric parameters, physical fitness, and bone growth factors among ACTN3 gene genotypes p.6
Table 5. Comparison of anthropometric parameters, physical fitness, and bone growth factors among the 4 groups Variables ACE II+ID and

Table 5.

Comparison of anthropometric parameters, physical fitness, and bone growth factors among the 4 groups Variables ACE II+ID and p.6
Table 6. Logistic regression analysis for association of ACE I/D, ACTN3 R577X genotype and other predictor variables with early  bone growth

Table 6.

Logistic regression analysis for association of ACE I/D, ACTN3 R577X genotype and other predictor variables with early bone growth p.7
Fig. 1. Comparison of physical fitness  and bone growth factors between the  ACE II+ID and ACTN3 XX and  ACE DD and ACTN3 RR+RX groups
Fig. 1. Comparison of physical fitness and bone growth factors between the ACE II+ID and ACTN3 XX and ACE DD and ACTN3 RR+RX groups p.7

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